Does Bariatric Surgery Reduce CVD Risk Factors in Adolescents?

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Increasing baseline age was independently associated with a lower likelihood of dyslipidemia remission in adolescents undergoing bariatric surgery.
Increasing baseline age was independently associated with a lower likelihood of dyslipidemia remission in adolescents undergoing bariatric surgery.

Adolescents who undergo bariatric surgery may experience a decrease in cardiovascular disease risk factors (CVD-RF), according to a study published in Pediatrics.

Researchers performed a teenager longitudinal assessment (ClinicalTrials.gov identifier: NCT00474318) on 242 adolescents (76% female, 72% white) who underwent Roux-en-Y gastric bypass surgery, vertical sleeve gastrectomy, and adjustable gastric banding (n=161, 67, and 14, respectively) to determine whether severely obese adolescents who underwent bariatric surgery experienced an improvement in CVD-RF.

Study results found "increasing weight loss was an independent predictor of normalization in dyslipidemia, elevated blood pressure (EBP), hyperinsulinemia, diabetes, and elevated high-sensitivity C-reactive protein."

In addition, compared with older participants, younger participants were more likely to experience a resolution of dyslipidemia, and females were more likely to experience a decrease in EBP compared with males. Participants at baseline without frank dyslipidemia or EBP were also found to have significant improvement in lipids and blood pressure measurements over time after bariatric surgery.

Limitations of this study included its overrepresentation of Caucasians, females, and individuals undergoing Roux-en-Y gastric bypass, which limits the generalizability of the study results. Further, the analysis of outcomes ceases after 3 years postintervention, and therefore long-term weight loss durability and CVD-RF results are unknown.

Investigators concluded that "[i]ncreased weight loss, female sex, and younger age predict a higher probability of resolution of specific CVD-RF." Overall, the data suggest there is a reduction in CVD risk development in adulthood for adolescents who receive bariatric surgery. Therefore, clinicians should be aware of these results and the importance of optimal procedural timing, as it affects clinical outcomes.

Reference

Michalsky MP, Inge TH, Jenkins TM, et al; Teen-LABS Consortium. Cardiovascular risk factors after adolescent bariatric surgery [published online January 8, 2018]. Pediatrics. doi: 10.1542/peds.2017-2485

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